Understanding and Managing Postpartum Anxiety

Postpartum anxiety (PPA) is a common yet often overlooked mental health condition affecting new parents. Approximately 10% of new parents experience postpartum anxiety (1), which can occur alone or alongside postpartum depression and/or postnatal depletion syndrome. This article helps parents understand postpartum anxiety, as well as its symptoms, risk factors, and management options, in order to help them navigate this challenging condition.

What Is Postpartum Anxiety?

Postpartum anxiety is a type of anxiety disorder that occurs after the birth of a baby. It involves excessive worrying, fear, and nervousness that can interfere with daily functioning and sometimes the ability to care for your newborn (2). Unlike the occasional general anxiety that many new parents feel, postpartum anxiety is more intense and persistent, often requiring professional intervention (2). Postpartum anxiety does not just affect mothers; fathers can be affected, too (3).

If you’d like to learn more about postnatal mental health conditions, you may enjoy these articles: Postpartum Depression In Dads, What Is Postnatal Depletion Syndrome? and Identifying and Managing Postpartum Depression

Symptoms

The symptoms of postpartum anxiety can vary but typically include a range of emotional, physical, and cognitive changes (2). Emotionally, new mothers might experience persistent worry that is difficult to control, feelings of dread or impending doom, and irritability or restlessness. 

New parents with postpartum anxiety might suffer from a racing heart, shortness of breath, dizziness, muscle tension, headaches, or chronic fatigue – even following the nights where they manage to get adequate rest. 

Cognitively, postpartum anxiety may cause difficulty concentrating or focusing, it may cause parents to experience intrusive thoughts or images, and exhibit hypervigilance, or cause them to be overly watchful or alert to potential dangers, especially concerning their baby. 

These symptoms can feel very disconcerting, especially during a time that is already emotionally intense. Being aware of the symptoms of postpartum anxiety allows new parents to get the support they need.

Risk Factors

Several factors may increase the risk of developing postpartum anxiety. This includes hormonal changes after childbirth and a personal or family history of anxiety disorders. Additional risk factors include a history of depression or other mental health disorders and high levels of stress or perfectionism (2). 

Social factors, such as lack of support from a partner, family, or friends, and major life changes (like having a baby!) or other significant stressors, like moving or job loss, can also contribute. 

Additionally, perinatal factors, including complications during pregnancy or childbirth or having a premature baby or a baby with health issues, can heighten the risk of developing postpartum anxiety.

Is it the Baby Blues, Postnatal Depletion Syndrome, Postpartum Depression, or Postpartum Anxiety?

There is a significant overlap between baby blues, postnatal depletion syndrome, postpartum depression, and postpartum anxiety, particularly in their shared symptoms of mood disturbances. 

The “baby blues” refers to the mild mood swings, tearfulness, and irritability that many new parents experience that typically resolve within a few weeks after delivery. 

Postnatal depletion syndrome involves prolonged physical and emotional exhaustion, often due to the demands of caring for a newborn combined with nutrient depletions resulting from the demands of pregnancy and lactation (4).

Postpartum depression is more severe and long-lasting than the baby blues, involving persistent sadness, feelings of hopelessness, and disinterest in activities once enjoyed (5). 

Postpartum anxiety specifically includes intense worry, panic attacks, and obsessive fears, often about the baby’s health and safety (2).

While each condition has distinct features, they can co-occur, and distinguishing between them can be challenging. Consulting with a trusted professional is the best way to get answers and the right support.

Are you looking for ways to support your energy levels as a busy parent? You might like these articles, too: Herbalism For Adults: My Top 6 Supportive Formulas For Busy Parents and Natural Energy Boosters For Exhausted Moms

Managing Postpartum Anxiety

Treatment for postpartum anxiety typically involves a combination of approaches tailored to the individual needs of the parent and can involve various modalities. 

Psychotherapy

Psychotherapy can be highly beneficial for parents experiencing postpartum anxiety. Cognitive Behavioral Therapy (CBT) is a modality that helps identify and change negative thought patterns and behaviors associated with anxiety. 

Interpersonal Therapy (IPT) focuses on improving relationships and communication skills, which can alleviate feelings of isolation and stress. 

Support groups provide a space for new parents to share experiences and gain support from others facing similar challenges, and are a great place to make parent friends.

Pharmacotherapy

Pharmacotherapy involves the use of medications to manage the symptoms of postpartum anxiety. While pharmacotherapy can be incredibly beneficial, it is the treatment modality that carries the most stigma. It is important for new parents to understand that taking care of their mental health benefits the entire family. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are commonly prescribed (2). It is important to be aware that these medications do make their way into breastmilk, but the benefits often outweigh the risks. A healthcare provider can help determine the safest options.

Lifestyle and Self-Care

The newborn days are not generally a time where parents find a lot of time for themselves. That said, finding ways to incorporate small moments of self care into your day can make a difference. Regular gentle exercise can help improve mood and overall well-being. Even light exercise, such as walking outside with your baby, can have a significant positive impact. 

Prioritizing rest is crucial, though it can be challenging with a newborn. Strategies such as napping when the baby sleeps, co-sleeping, and seeking help from your support system can help manage sleep deprivation. 

Mindfulness and relaxation techniques, like yoga, meditation, and deep-breathing exercises, can help manage stress and occasional anxiety. Don’t underestimate the impact of even five minutes of deep breathing each day. 

To learn more about how to support your own needs as a busy parent, read this article: Natural Energy Boosters For Exhausted Moms

Nutritional Support

A nutrient dense diet is always foundational for good health, and this is especially true during the postpartum period. Pregnancy, lactation, and sleep deprivation, which often accompanies the newborn phase, are significant stressors on the body and increasing our nutrient intake is one way that we can support a system that is already taxed.

In addition to supplements that support general nutrient intake, such as prenatal vitamins and food based supplements like beef liver capsules, supplements that support overall mental health may be helpful in managing postpartum anxiety. 

Omega-3 fatty acids may help alleviate occasional anxiety and support brain health (6). Magnesium supplementation can improve mood (7) and reduce occasional anxiety (8), and it is also important for muscle relaxation (9) and overall neurological function (10). Vitamin D is supportive of mood regulation (11), and B vitamins are essential for energy production and brain health (12). 

Interested in learning more about nutrition? Check out these articles: 10 Common Micronutrient Deficiencies & Inadequacies in the United States and The Basics Of Anti-Inflammatory Eating For The Whole Family

Herbal Supplements

Herbal remedies can be incredibly beneficial for managing anxiety, including postpartum anxiety. While most herbs are generally considered safe, it is important to consult with a provider before starting any new herbal treatment, especially when breastfeeding or taking prescription medication, to ensure there are no potential interactions or risks. 

Some herbal remedies that are supportive of a calm and regulated mood include:

1. Lemon Balm (Melissa officinalis): 

Known for its calming effects, lemon balm can help reduce occasional anxiety and promote relaxation (13). It can be consumed as a tea or taken in supplement form. 

2. Reishi (Ganoderma lucidum):

Reishi mushrooms are adaptogens that help the body manage stress and improve overall well-being (14). Reishi, and other medicinal mushrooms, can support immune system function, reduce fatigue, and support mental clarity. 

3. Hawthorn Leaf and Flower (Crataegus spp.): 

Hawthorn is perhaps most commonly used to support cardiovascular health (15), but it also has calming properties that can help reduce occasional anxiety (15) and improve emotional well-being. 

4. Chamomile (Matricaria chamomilla): 

Chamomile is well-known for its relaxing and anti-anxiety properties. Sipping chamomile tea is a routine that can help reduce anxiety and promote better sleep (16).

Many herbal remedies have not been sufficiently studied for use during pregnancy and lactation but have been used for hundreds of years by herbalists and are often regarded as safe despite the lack of scientific research. It is essential to purchase herbal remedies from a trusted source and to consult with a professional who is well versed in herbalism before starting a herbal regime.

Summary

Postpartum anxiety affects about 10% of new parents (1). It involves persistent and intense anxiety that can interfere with daily functioning and parenting. Understanding the symptoms, risk factors, and treatment options for postpartum anxiety is important for effective management. Treatment may include psychotherapy, pharmacotherapy, lifestyle changes, and nutritional and/or herbal support. Early recognition and intervention, along with support from healthcare providers and loved ones, can significantly improve the well-being of new parents experiencing postpartum anxiety.

References:

1. Postpartum and Antepartum Anxiety | Postpartum Support – PSI. (n.d.). Postpartum Support International (PSI). https://www.postpartum.net/learn-more/anxiety/
2. Cleveland Clinic. (2022, April 12). Postpartum Anxiety: Causes, Symptoms, Diagnosis & Treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22693-postpartum-anxiety
3. Leiferman JA, Farewell CV, Jewell J, Rachael Lacy, Walls J, Harnke B, Paulson JF. Anxiety among fathers during the prenatal and postpartum period: a meta-analysis. J Psychosom Obstet Gynaecol. 2021 Jun;42(2):152-161. doi: 10.1080/0167482X.2021.1885025. Epub 2021 Feb 25. PMID: 33632067.
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9. Karaki H. Magnesium as a modifier of smooth muscle contractility. Microcirc Endothelium Lymphatics. 1989 Feb-Apr;5(1-2):77-97. PMID: 2677641.
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14. Mi, X., Zeng, G. R., Liu, J. Q., Luo, Z. S., Zhang, L., Dai, X. M., Fang, W. T., Zhang, J., & Chen, X. C. (2022). Ganoderma Lucidum Triterpenoids Improve Maternal Separation-Induced Anxiety- and Depression-like Behaviors in Mice by Mitigating Inflammation in the Periphery and Brain. Nutrients, 14(11), 2268. https://doi.org/10.3390/nu14112268
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